Long-term readers will recognize Meador both as one of the stars in the film,, Money-Driven Medicine, and as the author of well-known satirical writings on the excesses in our medical system. They include “The Art and Science of Nondisease (the New England Journal of Medicine, 1965) and “The Last Well Person,” an essay he published as an “Occasional Note” in NEJM in 1994.

A few months ago, a young cardiologist told me that he rarely listens to hearts anymore. In a strange way, I was not surprised.

He went on to tell me that he gets all the information he needs from echocardiograms, EKGs, MRIs, and catherizations. In the ICU, he can even measure cardiac output within seconds. He told me that these devices tell him vastly more than listening to out-of-date sounds via a long rubber tube attached to his ear.

There was even an element of disdain. He said, “There is absolutely nothing that listening to hearts can tell me that I don’t already know from technology. I have no need to listen. So I don’t do it much anymore.”

In a recent interview with Cardiovascular Business, Criley explains: “When two-dimensional echocardiography became available in the mid-1970s it could have, and should have, provided a noninvasive way of seeing what the heart chambers and valves were doing when extra sounds or murmurs were created, but instead replaced bedside auscultation [listening to the heart].

Reading what Criley had to say, and thinking about Meador’s piece, it struck me that this is all part of what some call “the depersonalization of medicine.”

Meanwhile, in medical schools, Montross reveals, “virtual gross anatomy” lets students avoid the “messy” business of dissecting a real body. “This is a mistake,” says Montross.

Listening to the Heart

Criley’s theory that the stethoscope has become little more than a badge of honor is based on a study of physicians’ cardiac examinations.. . Criley was the lead author on a study that investigated these exams, published in the the December 2010 issue of Clinical Cardiology. Continue reading →